Some doctors and patients who participated in the recent US study on Electronic Health Records known as Open Notes are speaking out about EHRs. The survey says....
As my colleague Jenn Lonzer wrote recently, all of us are so connected nowadays via social networks and 24/7 communication that it is indeed “hard to believe that access to our electronic medical records (EMR) is so limited to the hospitals or clinics where we receive care.”
Jenn cited a study by the Society of Participatory Medicine released last February stating “nearly 75 percent of American adults surveyed believe it is very important that their critical health information should be easily shared between physicians, hospitals and other health care providers."
Open Notes study fuels Americans' desire for EHR access
Another study called Open Notes, published in the Annals of Internal Medicine, gave 13,564 patients at Beth Israel Deaconess Medical Center in Massachusetts, Geisinger Health System in Pennsylvania and Harborview Medical Center in Washington access to their EHRs.
The study provided a fascinating window into the world of interoperability and addressed a fundamental EHR question: “If you build it, will they come?”
5 key points about the EHR Open Notes study:
- The operating assumption behind the study was that “little information exists about what primary care physicians (PCPs) and patients experience if patients are invited to read their doctors' office notes.”
- The objective of the study was to evaluate the effect on both doctors and patients of enabling patient access to visit notes over secure Internet portals.
- The quasi-experimental trial involved 105 personal care physicians and 13,564 of their patients. Over a year patients received electronic links to notes their doctors had taken during their visit.
- The study examined the use of the EHR portal and electronic messaging by patients and focused on the participants’ (both physician and patient) perceptions of “behaviors, benefits, and negative consequences”.
- The results showed that patients accessed visit notes frequently, a large majority reported clinically relevant benefits and minimal concerns, and virtually all patients wanted the practice to continue. With doctors experiencing no more than a modest effect on their work lives, Open Notes seems worthy of widespread adoption.
Open Notes: The evidence is in
- More than 77 percent of patients in the Open Notes study reported that reading their notes helped them feel more in control of their care.
- More than 60 percent of patients reported doing better with taking their medications as prescribed.
- More than 86 percent of patients agreed that Open Notes would be an important factor in choosing a future doctor or health plan.
Watch this enlightening video to hear all sides of the interoperability debate as it relates to the Open Notes study. I found the physician comments especially candid and enlightening.
Where is One Notes going now?
Based on an article published in the MedCity News, Open Notes appears to be advancing from a study into a movement.
Since the study was initially published in 2014 in the New England Journal of Medicine, the idea of giving patients access to their EHRs has picked up steam.
After the first year of Open Notes, says MedCity News, “99 percent of the participating patients surveyed said they wanted access to continue, while 85 percent said the ability to view physician notes would affect their choice of healthcare provider in the future."
Photo: Mark Fugarino
Not one of the initial 100 primary care physicians in Open Notes “dropped out after the year, despite initial concerns about patients not understanding their documentation or about being overwhelmed by patient questions.”
Since the pilot study ended in 2013, Open Notes has grown to include nearly 5 million patients...It’s not just a one-time thing. This started out as a research project, and now we think of it as a movement.” - Janice Walker, a registered nurse and researcher at Beth Israel Deaconess Medical Center in Boston, which led the study.
For more interesting reading on the subject of EHRs and interoperability, check out this New York Times article, “The Healing Power of Your Medical Records” published this past March.
Top photo: Intel Free Press
The nuviun blog is intended to contribute to discussion and stimulate debate on important issues in global digital health. The views are solely those of the author.